Management of bone metastases (BMs) in patients (pts) with neuroendocrine neoplasms (NENs): Findings from a retrospective study.

Angela Lamarca, Jon Lim, Hussain Raja, Paolo D'Arienzo, Jorge Barriuso, Mairead Mcnamara, Richard Hubner, Was Mansoor, Juan Valle

Research output: Contribution to conferenceAbstractpeer-review


BMs are rare in NENs; optimal management warrants global consensus.

To review the current management and outcomes of pts with BMs in NENs.

This retrospective study included consecutive pts with a NEN (excluding G3 lung) treated at an ENETS Centre of Excellence (April’02-March’18). Pts demographics, nature of BMs, treatment and overall survival (OS) were evaluated (SPSS v23.0/STATA v12).

Of 1459 pts screened, 85 (7%) had BMs. Primary tumour: gastro-entero-pancreatic 49%, lung 25%, unknown primary 20%, and “others” 6%; grade 1-2 67%; 41% functional. BMs were ‘widespread’ in 61% of pts and synchronously diagnosed with other metastatic sites in 55%. In 45% of pts, BMs were ‘late events’ (non-synchronous), with median time-to-BMs of 14.0 months(m) (95%CI 3.1-24.9). BMs were symptomatic in 78% of pts: frequency and time-to-event (if asymptomatic at diagnosis of BM) for pain was 61% and 2.2m (95%CI 1.8-6.6), hypercalcaemia: 4% and 14.6m (95%CI 12.9-72.0) and skeletal-related events: 20% (including fracture [11% and 7.7m (95%CI 0.3-14.9)] and cord compression [11% and 14.2m (95%CI 0.3-118.9)]), respectively. Management of BMs included: analgesia 44%, radiotherapy 34%, bisphosphonates 22% and surgery 2%. Median OS from identification of BMs was 31.0 months (95%-CI 19.6-42.4) and 18.9 months (95%-CI 8.7-29.1) from time of development of BM-related symptoms. On multivariable Cox Regression, age (p 0.008) and performance status (p 0.001) were independent factors associated with shorter OS.

Most pts with BMs will become symptomatic with variable time-to-symptom development. Optimal guidance on management of BMs to improve pts outcomes and quality of life is necessary.
Original languageEnglish
Publication statusPublished - 6 Mar 2019
Event16th Annual ENETs conference - Barcelona, Barcelona, Spain
Duration: 6 Mar 20198 Mar 2019


Conference16th Annual ENETs conference


  • Neuroendocrine tumours
  • Bone metastases

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


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